Near misses and presenteeism among paramedics

Presenteeism in front-line physicians involved in COVID-19-related clinical practice: a national survey of employed physician members of the Japan Medical Association

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic may have increased the rate of presenteeism among front-line physicians. Presenteeism is the term used to describe attendance at work despite ill health that would normally prompt rest or absence from work. This study aimed to examine the associations between COVID-19 clinical practice and presenteeism among physicians.

METHODS

A cross-sectional study was conducted from December 2021 to January 2022. The questionnaires were distributed to 21,737 employed physicians who were members of the Japan Medical Association. Presenteeism was measured by the Work Functioning Impairment Scale. Multiple logistic regression analysis was used to evaluate the association between COVID-19 clinical practice and presenteeism.

RESULTS

Overall, 3,968 participants were included in the analysis, and presenteeism was observed in 13.9% of them. The rate of presenteeism significantly increased with both the number of COVID-19 patients treated and the percentage of work time spent treating these patients (both P values for trend < 0.001). In comparison to those not currently engaged in the treatment of COVID-19 patients, presenteeism was significantly higher among front-line (adjusted odds ratio [aOR] = 1.71, 95% confidence interval [CI]: 1.16-2.53) and second-line physicians supporting those in the front-line (aOR = 1.45, 95% CI: 1.17-1.78). There was no association between involvement in COVID-19 vaccination services and presenteeism.

CONCLUSIONS

The burden on front-line and second-line physicians in COVID-19 clinical practice must be minimized. Employed physicians also need to recognize the importance of communicating with their workplaces about presenteeism.

Trends, variations and prediction of staff sickness absence rates among NHS ambulance services in England: a time series study

OBJECTIVES

Our aim was to measure ambulance sickness absence rates over time, comparing ambulance services and investigate the predictability of rates for future forecasting.

SETTING

All English ambulance services, UK.

DESIGN

We used a time series design analysing published monthly National Health Service staff sickness rates by gender, age, job role and region, comparing the 10 regional ambulance services in England between 2009 and 2018. Autoregressive Integrated Moving Average (ARIMA) and Seasonal ARIMA (SARIMA) models were developed using Stata V.14.2 and trends displayed graphically.

PARTICIPANTS

Individual participant data were not available. The total number of full-time equivalent (FTE) days lost due to sickness absence (including non-working days) and total number of days available for work for each staff group and level were available. In line with The Data Protection Act, if the organisation had less than 330 FTE days available during the study period it was censored for analysis.

RESULTS

A total of 1117 months of sickness absence rate data for all English ambulance services were included in the analysis. We found considerable variation in annual sickness absence rates between ambulance services and over the 10-year duration of the study in England. Across all the ambulance services the median days available were 1 336 888 with IQR of 548 796 and 73 346 median days lost due to sickness absence, with IQR of 30 551 days. Among clinical staff sickness absence varied seasonally with peaks in winter and falls over summer. The winter increases in sickness absence were largely predictable using seasonally adjusted (SARIMA) time series models.

CONCLUSION

Sickness rates for clinical staff were found to vary considerably over time and by ambulance trust. Statistical models had sufficient predictive capability to help forecast sickness absence, enabling services to plan human resources more effectively at times of increased demand.

Relationship between impaired work function and coping behaviors in workers with low back pain

OBJECTIVES

The aim of the present study was to clarify the relationship between work functional impairment levels and three coping behaviors of workers with low back pain, which were about seeking medical attention, taking over-the-counter drugs, and taking self-care.

METHODS

We conducted a cross-sectional study on 14 Japanese companies in 2016. Work function impairment was measured using the Work Functioning Impairment Scale. Logistic regression analyses were conducted for the three coping behaviors and odds ratios (ORs) calculated for work functional impairment levels.

RESULTS

We analyzed 2232 subjects; 226 were women and 790 worked on production lines. 688 workers had sought medical attention, 436 had taken over-the-counter medication, and 1225 had engaged in self-care. Those seeking medical attention were associated with severe work function impairment compared with no work function impairment (adjusted OR = 2.84, 95% confidence interval: 1.82-4.45, p < .001). We observed a trend for the association between over-the-counter drug use with high levels of work function impairment (adjusted OR: 1.19 for low, 1.35 for moderate, 1.65 for severe). There was no apparent relationship between self-care and the degree of work functional impairment.

CONCLUSION

In workers with low back pain, severe work functional impairment may promote medical attention and over-the-counter medication use, but it would not encourage self-care, such as stretching or exercise. Therefore, workplaces need to provide special support to help them take care of themselves. Therefore, it is desirable to provide good support for self-care in the workplace.

Near-miss incidents owing to fatigue and irregular lifestyles in ambulance personnel

We aimed to investigate the association between fatigue and near-miss incidents and between irregular lifestyles and fatigue in ambulance personnel. In this cross-sectional study, we used a self-administered questionnaire and ambulance dispatch records during November 2017. We performed multiple logistic regression; in total, 254 ambulance staff were eligible for inclusion in the analysis. The adjusted odds of near-miss incidents were 3.19 times higher for participants with higher fatigue than for those with normal fatigue, with statistical significance. Fatigue was significantly associated with the monthly number of ambulance dispatches, office working hours, mealtimes, daytime napping hours, and napping hours during a night shift. In this study, we demonstrated a positive association between fatigue and near-miss incidents among ambulance personnel. Additionally, our results suggest that irregular lifestyles are a root cause of fatigue in ambulance personnel.